AJP - Endocrinology and Metabolism, Vol 272, Issue 1 E59-E67, Copyright © 1997 by American Physiological Society
Metabolic adaptation to protein restriction in insulin-dependent diabetes mellitus
L. J. Hoffer, A. Taveroff and A. Schiffrin
McGill Nutrition and Food Science Centre, McGill University, Montreal, Quebec, Canada.
Eight normal subjects, four subjects with intensively treated
insulin-dependent diabetes mellitus (IDDM), and six subjects with
conventionally treated IDDM consumed a test meal of 0.5 g protein and 10
kcal per kg body weight, first while adapted to a conventional diet high in
protein, and then again after 5 days of dietary protein restriction.
Metabolic N balance (N consumed minus urea production) and net protein
utilization were measured over the 9 h after consumption of the test meal,
as was recovery in urea of 15N from a tracer dose of [15N]alanine included
in each test meal. After the first test meal, N balance and net protein
utilization were similar and close to zero for all groups. After the second
test meal, N balance and net protein utilization became positive for all
groups (P < 0.05) but significantly less so (P < 0.05) for the
conventionally treated than for the normal and intensively treated diabetic
subjects. 15N recovery in urea was reduced for all groups after the second
test meal (P < 0.05) but probably less effectively (P < 0.09) for the
conventionally treated diabetic subjects. Metabolic adaptation to protein
restriction may be less effective than normal in conventionally treated
IDDM.
